As Black mothers and infants continue to face disproportionately high rates of pregnancy-related complications and death, a growing number of communities are testing an unconventional approach to improving maternal health: giving pregnant women cash with few or no restrictions on how they spend it.

Early findings from guaranteed income programs suggest that direct financial assistance can reduce stress, improve access to prenatal care and potentially lead to healthier births.

Black women in the United States face a maternal mortality rate roughly three times that of White women, while Black infants are more likely to be born prematurely or die before their first birthday. Advocates say financial insecurity, inadequate healthcare access and longstanding racial disparities contribute to the crisis.

The programs provide monthly payments to expectant mothers, allowing them to address immediate needs such as housing, transportation, groceries and childcare.

“This makes so much sense to me,” said Tamara Mason of the March of Dimes, who helped oversee a guaranteed income pilot program. “Why isn’t everyone doing this?”

In Atlanta, the March of Dimes partnered with community organizations to provide 25 low-income pregnant women with $1,000 monthly during pregnancy and through their babies’ first year.

Participants were selected from neighborhoods experiencing high poverty rates and limited access to maternal healthcare. More than 110 women applied for the available spots.

The program also provided diapers, baby supplies and access to community support services.

An evaluation conducted by Emory University found encouraging early results. According to program organizers, participants reported a 20% reduction in financial stress and a 66% decline in feelings of hopelessness. Prenatal outcomes also showed positive trends.

Researchers caution, however, that the small pilot program cannot establish whether cash payments alone caused improvements in birth outcomes.

Similar initiatives are underway elsewhere.

In New Orleans, another March of Dimes program offers eligible pregnant women up to $12,000, distributed either as monthly payments or a lump sum. Participants have used the assistance for housing, transportation, insurance and food.

Program officials say the flexibility allows mothers to address financial problems that traditional healthcare services cannot resolve.

The importance of that assistance became especially apparent when interruptions in federal food benefits forced some families to redirect more of their payments toward groceries.

Michigan’s Rx Kids initiative has also attracted national attention. The program provides financial support during pregnancy and infancy, with research in Flint suggesting significant improvements in newborn survival.

Advocates believe these initiatives demonstrate that economic stability should be considered an essential part of maternal healthcare.

Financial stress can affect pregnancy in multiple ways, from making it difficult to afford nutritious food to preventing expectant mothers from attending medical appointments. Unstable housing and transportation challenges can further complicate access to care.

However, guaranteed income is not a complete solution. Organizers acknowledge that some participants continue to experience housing instability, domestic violence and other serious challenges despite receiving financial assistance.

The growing interest in direct payments comes as federal healthcare and social assistance programs face uncertainty, including potential Medicaid reductions that could disproportionately affect low-income mothers and children.

Medicaid finances a substantial share of births nationwide, making changes to its funding particularly consequential for maternal healthcare access.

At the federal level, lawmakers have introduced legislation addressing maternal health disparities through investments in housing, nutrition, healthcare services and the maternal health workforce.

Sen. Cory Booker of New Jersey has also advocated expanding financial assistance to families, pointing to the temporary expansion of the federal child tax credit in 2021, which helped reduce child poverty.

“I believe that we need to, for moms, flood resources to them through things like the child tax credit,” Booker said during an August briefing on the Black Maternal Health Momnibus Act.

Supporters argue that helping families meet basic needs during pregnancy and early childhood can produce benefits extending well beyond childbirth.

Danielle Atkinson of the Mothering Justice Action Fund said improving maternal health requires sustained investment in Black mothers and their families.

“Black mamas deserve access to quality healthcare that sees us, listens to us, and understands us at every step of the way,” Atkinson said.

As more communities evaluate guaranteed income programs, researchers and policymakers will be watching whether the early improvements can be replicated on a larger scale.

For advocates, the central question is whether providing financial security during pregnancy can help prevent avoidable complications and give more mothers and babies a healthier start.